Water
Pollution Report FormIf you are concerned
about potential illegal water pollution into a stream or other body of
water, please fill out the form below.Any photographs
documenting the situation are always helpful.

You
can also report a concern by calling the Skagit County Public Works Surface
Water Section at (360) 416-1400

Your Name*
Last:
First:
MI

Your Home Telephone
Number*
(555-555-5555):

Your Alternate Phone (Cell/Work)*:

Email*:

What type of
incident do you wish to report? Check all that apply:

Failing septic systems
Livestock in stream
Manure management
Dumping Down a Storm Drain
Suspicious Discharge from Pipe into a Stream
Water in Stream is an Unusual Color
Water in Stream Smells Strange
Suspicious Suds or other Substance Floating on Water
Fish or other Aquatic Creatures appear to have Died
Other (explain)

Where did the
incident take place?

Address Street /
Number

Location of Incident (Cross streets, body of water impacted, please
be as specific as possible):

Date of Incident
(mm/dd/yyyy):
Time of Observation (hh:mm am/pm):

Please add any
details that might help a responder locate the site and know what to
look for to take a sample.